BERKELEY, CA (UroToday Inc.) - Bladder distention has been one of the mainstays in the diagnosis and treatment of interstitial cystitis (IC). Unfortunately, the method of short bladder distention (SBD) has not been standardized.

Drs. Turner and Stewart from Western General Hospital in Edinburgh, United Kingdom wished to determine how urologists in the UK performed SBD. They conducted a self-reported survey to answer this question. Their findings were published in the October 2004 edition of Neurourology and Urodynamics.

They sent questionnaires to all UK consultant urologists to determine their indications for SBD, how it was performed, the evaluation of outcomes and their awareness of evidence based techniques. They sent out 533 questionnaires and received 244 (46%) replies. Of the respondents, 87% performed SBD. The rationale for the use of SBD was: 40% for the investigation and treatment of IC only, 46% for the investigation and treatment of IC as well as the management of bladder storage symptoms, and 8% used it for the treatment of storage symptoms alone.

The SBD techniques used were diverse. Seventy percent distended the bladder once, 21% twice, 5% three times, and 3% varied the number of distensions depending on their visual findings. The mean duration of the distension, when done once, was 5.4 minutes, and it was 3.90 minutes when multiple distentions were performed. Total durations ranged from 1 to 20 minutes. The median pressure used for distention was 100cm of water. Ninety-one percent determined bladder capacity by observing the cessation of fluid inflow.

None were able to cite peer-reviewed evidence to support their practices. Estimates of patient benefit from hydrodistention were 0 to 50%.

The authors conclude that although SBD is commonly done, there is no standardized approach. They recommend that a standardized technique be developed in order to improve the investigation and management of IC.